Swiatkowska-Stodulska Renata, Kazimierska Ewa, Weyer-Hepka Jolanta, Dworakowska Dorota, Lubińska Monika, Gnacińska Maria, Bakowska Alicja, Czestochowska Eugenia
Klinika Chorób Wewnetrznych, Endokrynologii i Zaburzeń Hemostazy Instytutu Chorób Wewnetrznych AM w Gdańsk.
Pol Arch Med Wewn. 2005 Apr;113(4):346-51.
Portal vein thrombosis is one of the main prehepatic causes of portal hypertension. The most frequent causes of thrombosis in this localization, apart from hepatic cirrhosis, are the following: acute inflammatory diseases and abdominal cancers, traumas, proliferative diseases of the hematopoietic system. In recent years attention was given to disorders in hemostasis, such as thrombophilia, in the course of which thrombosis development is particularly common. The authors present 10 patients after an incident of portal vein thrombosis, in which primary hepatic pathology was excluded and tests directed at thrombophilia were performed. In seven patients abnormalities in the examined parameters were found, and what is more, in two cases they had a complex character and involved more than one parameter. In five patients hyperhomocysteinemia was found. Among them, in two patients there was also a decreased protein S activity and in one of them there was also APC-resistance. In the next two patients there were abnormalities in one of the examined parameters - APC-resistance. Hyperhomocysteinemia was found in all patients with idiopathic thrombosis, and in one of them there were concurrent changes in protein S activity and APC-resistance. In patients with the history of portal vein thrombosis diagnostics of thrombophilia should be performed.
门静脉血栓形成是肝前门静脉高压的主要原因之一。除肝硬化外，该部位血栓形成最常见的原因如下：急性炎症性疾病和腹部癌症、创伤、造血系统增殖性疾病。近年来，人们关注止血障碍，如血栓形成倾向，在此过程中血栓形成尤为常见。作者介绍了10例门静脉血栓形成事件后的患者，其中排除了原发性肝脏病变并进行了针对血栓形成倾向的检测。在7例患者中发现了检测参数异常，此外，在2例患者中这些异常具有复杂性且涉及多个参数。在5例患者中发现了高同型半胱氨酸血症。其中，2例患者蛋白S活性也降低，1例患者还存在活化蛋白C抵抗。在接下来的2例患者中，检测参数之一存在异常——活化蛋白C抵抗。在所有特发性血栓形成患者中均发现高同型半胱氨酸血症，其中1例患者蛋白S活性和活化蛋白C抵抗同时发生改变。对于有门静脉血栓形成病史的患者，应进行血栓形成倾向的诊断。
